Fluoroquinolones and tendon disorders

Area of Science:

• Pharmacology
• Toxicology
• Infectious Diseases

Background:

• Fluoroquinolones are potent oral antibiotics with increasing use in diverse patient populations.
• Adverse events, including rare but severe tendinopathy, are a growing concern with broader fluoroquinolone prescription.

Purpose of the Study:

• To review the mechanisms, clinical presentation, and risk factors of fluoroquinolone-associated tendinopathy.
• To highlight the need for a more cautious approach to fluoroquinolone prescribing.

Main Methods:

• Literature review of published case reports and data from the World Health Organization Collaborating Centre for Drug Monitoring.
• Discussion of chemical properties, mode of action, pharmacokinetics, and clinical data related to tendon toxicity.

Main Results:

• Fluoroquinolone-associated tendinopathy is a rare but debilitating adverse reaction.
• Mechanisms underlying this fluoroquinolone-specific toxicity remain largely unknown.
• Current in vitro or in vivo models cannot predict this musculoskeletal toxicity.

Conclusions:

• The increasing use of fluoroquinolones necessitates a re-evaluation of their prescription patterns.
• A more prudent use of fluoroquinolones is warranted due to unpredictable toxicity and contribution to antibiotic resistance.